Underestimation of Cirrhosis-Related Mortality in the Medicare Eligible Population, 1999-2018

Area of Science:

• Hepatology
• Geriatric Medicine
• Public Health

Background:

• The increasing burden of cirrhosis, especially in the elderly population, is a growing public health concern.
• An updated definition of cirrhosis demonstrates high accuracy (>90% PPV) in identifying the condition and its complications.
• Existing data may underestimate cirrhosis-related mortality, with a potential disproportionate impact on older individuals.

Purpose of the Study:

• To investigate trends in liver-related mortality among the elderly using an updated definition of cirrhosis.
• To identify demographic and geographic disparities in cirrhosis-related mortality within the elderly population, including gender, race, and rurality.

Main Methods:

• Utilized an updated definition of cirrhosis with high positive predictive value.
• Analyzed liver-related mortality trends specifically within the elderly demographic.
• Examined changes in mortality rates across subsets of gender, race, and rurality.

Main Results:

• Preliminary analysis suggests cirrhosis-related mortality may be underestimated.
• The elderly population appears to be disproportionately affected by cirrhosis-related mortality.
• Trends varied across gender, race, and rurality, indicating specific vulnerable subgroups within the elderly.

Conclusions:

• Cirrhosis-related mortality, particularly in the elderly, warrants further investigation due to potential underestimation.
• The updated cirrhosis definition provides a more accurate tool for assessing mortality burden.
• Targeted public health interventions may be necessary to address disparities in cirrhosis mortality among elderly populations based on demographic and geographic factors.